Risk of post-operative and maxilofacial complications in people living with HIV: protocol for a systematic review

Abstract

Introduction: In recent decades, HIV infection and its progression to AIDS have had a significant global impact. In 2023, there were 39.9 million people living with HIV and 1.3 million new infections. In Latin America, new cases increased by 21% between 2010 and 2019. HIV destroys CD4+ lymphocytes, raising the risk of opportunistic infections and cancers. The WHO defines advanced HIV disease as a CD4+ count of less than 200 cells/mm³. Although antiretroviral therapy has improved the survival and morbidity of people with HIV, challenges remain in managing complications. In developed countries, oral complications have decreased, but they remain common in developing countries. The literature on surgical complications in people living with HIV is scarce and inconclusive, and current clinical guidelines are based on expert opinions. Objective: This systematic review aims to determine whether there is an association between living with HIV and the risk of complications following oral surgery. Methodology: Comparative studies evaluating the prevalence of oral and maxillofacial surgical complications in people living with HIV will be included. Data synthesis will be conducted through narrative synthesis and descriptive tables, and the certainty of evidence will be assessed using the GRADE approach. Expected result: This review will provide crucial information for clinical and policy decisions and identify areas for future research. Expected complications include alveolitis, bleeding, facial space abscess, paresthesia, bruising, hematoma, and fracture.